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- Title
Costal cartilage fractures in blunt polytrauma patients - a prospective clinical and radiological follow-up study.
- Authors
Nummela, Mari T.; Pyhältö, Tuomo T.; Bensch, Frank V.; Heinänen, Mikko T.; Koskinen, Seppo K.
- Abstract
<bold>Purpose: </bold>To assess the healing of costal cartilage fractures (CCFX) in patients with blunt polytrauma with follow-up imaging and clinical examination. Effect on physical performance and quality of life (QoL) was also evaluated.<bold>Methods: </bold>The study group comprised twenty-one patients with diagnosed CCFX in trauma CT. All the patients underwent MRI, ultrasound, ultra-low-dose CT examinations, and clinical status control. The patients completed QoL questionnaires. Two radiologists evaluated the images regarding fracture union, dislocation, calcifications, and persistent edema at fracture site. An attending trauma surgeon clinically examined the patients, with emphasis on focal tenderness and ribcage mobility. Trauma registry data were accessed to evaluate injury severity and outcome.<bold>Results: </bold>The patients were imaged at an average of 34.1 months (median 36, range 15.8-57.7) after the initial trauma. In 15 patients (71.4%), CCFX were considered stable on imaging. Cartilage calcifications were seen on healed fracture sites in all the patients. The fracture dislocation had increased in 5 patients (23.8%), and 1 patient (4.8%) showed signs of a non-stable union. Four patients (19.0%) reported persistent symptoms from CCFX.<bold>Conclusion: </bold>Non-union in CCFX is uncommon but may lead to decreased stability and discomfort. Both clinical and radiological examinations play an important part in the post-traumatic evaluation of CCFX. CT and MRI visualize the healing process, while dynamic ultrasound may reveal instability. No significant difference in QoL was detected between patients with radiologically healed and non-healed CCFX. Post-traumatic disability was mostly due to other non-thoracic injuries.
- Subjects
BLUNT trauma; CARTILAGE fractures; QUALITY of life; WOUNDS &; injuries; RIB fractures; COMPUTED tomography; LONGITUDINAL method
- Publication
Emergency Radiology, 2022, Vol 29, Issue 5, p845
- ISSN
1070-3004
- Publication type
journal article
- DOI
10.1007/s10140-022-02066-w